Wearing dentures not only helps replace missing teeth but can also help older adults regain confidence in their appearance. However, these custom-made appliances meant to restore a perfect smile may have negative impacts on a senior’s overall nutrition and health, according to a recent study.
Researchers from Regenstrief Institute and the Indiana University School of Dentistry (IUSD) examined dental and health records from more than 10,000 people and found a significant decline in certain nutritional markers such as serum albumin, calcium and creatinine among denture patients within two years of receiving their dentures.
They also found declining trends of serum albumin, protein, calcium and hemoglobin among denture wearers compared to non-denture wearers.
“Tooth loss and receiving dentures are life-changing events for a person,” said Dr. Thankam Thyvalikakath, DMD, PhD, senior author of the study. “Dentures, although better than not having any teeth, do not provide the same chewing efficiency as natural teeth and therefore may alter eating habits.”
Based on these findings, Thyvalikakath and her colleagues warn that older adults and their caregivers need to be aware of the risk of undernutrition when they receive treatment to replace lost or missing teeth.
How do dentures change eating habits?
Adults who have dentures are forced to eat softer foods and a more pureed diet – which often includes foods that are typically higher in carbohydrates but lower in protein and fiber – and fewer vegetables. This creates an unbalanced diet and makes nutrition challenging for people, especially older adults who are diabetic.
In addition, dentures (especially ones that don’t fit well) can cause decreased levels of saliva production and can make it difficult to chew certain kinds of food, said Dr. Tim Donley, DDS, MSD, an expert in the treatment of gum disease and dental implants and Philips Sonicare Partner.
“Due to this discomfort, some patients avoid certain foods and lower their daily food intake, which can lead to malnourishment,” he said. “Reduced chewing efficiency can also lead to an overall change in diet favoring softer, less fiber-containing foods. Such changes can affect overall health.”
Reduced chewing efficiency can also lead to an overall change in diet favoring softer, less fiber-containing foods. Such changes can affect overall health.
Donley added due to potential chewing and swallowing difficulties, older denture-wearing patients as seen in the study are often not getting the necessary nutrition to manage health outcomes.
Dentures may also alter the taste of food, increasing both bitter and sour taste sensations, Mia Syn, MS, RDN, a nutritionist and Philips Sonicare Partner, told SeniorsMatter. This can cause some users to avoid fruits, vegetables and whole grains because they’re harder to chew but have significantly lower serum levels of vitamins C and E, folate and others.
“Since it is harder to chew or taste may be altered, it could lead to the consumption of fewer meals or smaller meals with less nutritional value,” Syn said. “There is also an increased risk of malnutrition in older adults who wear dentures related to difficulty chewing foods.”
According to Thyvalikakath, more research is still needed to determine what a decline in nutritional markers means and how it correlates to an individual’s overall health.
“I don’t think we have a good understanding about healthy values versus normal values. All I can say is the numbers are more towards the lower end of the normal range value, but we are unable without doing more investigation [to say] how it impacts your physical health,” she said. “It’s hard to tell the difference between a healthy value and normal value.”
What to watch for as a caregiver or loved one
Caregivers should be aware of a senior denture wearer’s risk for undernutrition or malnutrition. Here are some things to look out for, as advised by Donley, Thyvalikakath and Dr. Sukhdeep Dhaliwal, DDS, MD:
- Denture fitting: Dentures that don’t fit well can rub against gum tissue, causing inflammation and bleeding, which can increase the risk of infection.
- Gagging or other discomforts: If your loved one is complaining about this, it can cause them to avoid certain foods or not eat at all.
- Weight loss or muscle loss: If a denture wearer is not eating enough or getting enough nutrients, it can result in the loss of weight and muscle mass. Some may also eat less at mealtimes due to chewing or swallowing difficulties.
- Weight gain: Some patients may gain weight because they’re only eating calorie-rich foods.
If your loved one is showing any of these signs, experts recommend taking them to the dentist or nutrition specialist to address these issues.
“A healthy oral care regimen even with dentures is extremely important to be mindful of,” Donley said. “Oral health affects and determines one’s overall health, so ensuring hygiene protocols are followed is integral for overall wellness.”
The researchers said the study is not saying dentures are bad or should not be pursued—only that older adults and caregivers should be aware and conscious of potential diet and nutrition modifications that can occur and should speak with a health care professional if they notice any changes.
Caregivers can help ensure proper dental hygiene and overall health in a senior with dentures:
- Brush teeth twice a day, along with the gums, tongue and roof of the mouth.
- Ensure dentures fit properly.
- Wear dentures during the day and take them out at night.
- Clean dentures and soak them in water or a proper cleaning solution.
- Blending food in a food processor or blender makes foods easier to chew.
- Encourage a balanced diet composed of fruits, vegetables, proteins, rich foods, grains and dairy.
- Limit snacking. (The more you eat between meals, the more likely you are to introduce acids to your teeth.)
- When snacking, limit sugary drinks and treats.
- Visit the dentist for dental screenings every six months.
- Consider dental implants if there are continued difficulties.
- Work with a dietitian if needed to discuss diets and certain food consumption.